As many as 20% of GP referrals to secondary care disappear into a “black hole,” it was claimed today.

Hospitals are cancelling, losing or rejecting referrals while, in some cases, hard-pressed practice teams never make them, according to Healthwatch England. The findings come from a survey of 2,000 people who have undergone GP referrals in the last five years.

The acting chair of the British Medical Association’s GP committee in England, Dr Kieran Sharrock warned of a “ merry go round” of new referral procedures. This could lead to staff “not knowing who to send referrals to, which form to use and how to follow it up”.

He told The Times there should be “a much more transparent system so that patients know when they have been referred, who and to which department they have been referred, and how they can track the referral”.

Healthwatch England national director Louise Ansari said: “Falling into this ‘referrals black hole’ is not just frustrating for patients, but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need. This adds more burden on already stretched services, making things even harder for the doctors and nurses trying to provide care. It’s crucial that more administrative support is put in place to improve referral processes and ensure that everyone who needs treatment can access it as quickly as possible, in the right setting and in a way that meets their needs.”

A spokeswoman for NHS England said the analysis was “misleading”. She said: “It fails to consider several reasons a patient may not have heard further about a referral, including around 1.2 million people between April and December whose referral was returned with specialist advice, and those who may be on the waiting list for an appointment. The NHS is working hard to improve information for patients who have been referred by their GP including through the introduction of the My Planned Care platform so patients can track their referrals with local areas creating standards to ensure that specialist advice is given to GPs within 72 hours of a referral.”